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Evidence summaries

Pre-Operative Chemotherapy in Non-Small Cell Lung Cancer

Pre-operative chemotherapy may increase survival in patients with non-small cell lung cancer compared to surgery alone. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 7 trials with a total of 988 patients. Pre-operative chemotherapy increased survival (hazard ratio 0.82, 95% CI 0.69 to 0.97). This is equivalent to an absolute benefit of 6%, increasing overall survival across all stages of disease from 14% to 20% at 5 years.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions, e.g wide range of post-operative treatments) and by indirectness (patient level characteristics inconsistently reported making comparisons between the trials impossible; six of the seven RCTs were stopped early).

    References

    • Burdett SS, Stewart LA, Rydzewska L. Chemotherapy and surgery versus surgery alone in non-small cell lung cancer. Cochrane Database Syst Rev 2007 Jul 18;(3):CD006157. [PubMed]

Primary/Secondary Keywords